Diabetes may be associated with several types of hair loss due to insulin resistance, autoimmune activity, stress, poor circulation, and certain medications. The relationship varies by diabetes type, with links to alopecia areata, pattern hair loss, and temporary shedding, and is influenced by overall blood sugar control and treatment. A trichological assessment can help you find out whether diabetes is contributing to your hair loss.
This article explains how the major types of diabetes are linked to hair loss. It explores possible biological, autoimmune, hormonal, and treatment-related connections, and explains why hair thinning may occur, who is most at risk, and how different diabetes types and treatments play a role. You’ll also find practical steps for diagnosis and hair loss management, as well as effective hair loss treatments for patients with diabetes.
Key takeaways
Diabetes is a health condition characterised by chronically high blood glucose levels due to the body’s inability to produce enough insulin, use insulin effectively, or both. [1].
Glucose is your main source of energy, but it needs insulin to enter cells where it can be used. People with diabetes either don’t produce enough insulin or their bodies don’t use it effectively, which means glucose stays in your blood and isn’t used by the cells. That’s why some people with diabetes must inject insulin every day.
There are several types of diabetes. Type 1 diabetes is an autoimmune condition that’s often diagnosed in childhood, whereas type 2 diabetes tends to develop later in life, and is linked with age, weight, ethnicity, and family history of the condition [2]. Gestational diabetes affects pregnant women, usually in the latter half of pregnancy.
Uncontrolled diabetes can cause further health problems, including issues with your vision, kidneys, and heart. In rare cases, diabetes may also be linked with hair loss [3-5].
Research indicates there is some correlation between diabetes and hair loss, though findings differ as to whether diabetes causes hair loss, or hair loss is a symptom of diabetes.
Here, we’ll look at the main types of diabetes and what the research shows about their links to hair loss.
Type 1 diabetes is an autoimmune condition, which occurs when the body’s immune system attacks the cells in the pancreas that are responsible for making insulin. Research suggests that people with type 1 diabetes may be more likely to have other autoimmune conditions, including alopecia areata [6-7].
Alopecia areata is characterised by patchy hair loss on the scalp. Patches are normally round or oval in shape. Patches can linger for several years or grow back spontaneously, making it a highly unpredictable condition that’s tricky to treat.
Early stage alopecia areata:
Late stage alopecia areata:
Studies suggest that alopecia areata may be a risk factor for the development of diabetes, including for patients’ relatives [7-9].
Type 2 diabetes has similar symptoms to type 1, but it develops as a result of your genetics and lifestyle. Potential causes include being overweight, having a high waist circumference, having high blood pressure, and having a family history of type 2 diabetes.
Research also suggests that having androgenetic alopecia — also known as pattern baldness — could also be a risk factor for developing low insulin sensitivity and insulin resistance [10-11]. Over time, this can lead to type 2 diabetes.
That said, some studies have shown that high levels of dihydrotestosterone (DHT) — a key hormone involved in the development of male pattern baldness — may be linked with a lower risk of insulin resistance and diabetes among older men [12]. High DHT levels are linked with increased hair loss from male pattern baldness.
Male pattern baldness is a very common condition that affects over 80% of men over their lifetime [13]. So losing your hair isn’t necessarily an indicator of diabetes or prediabetes. If you do have Norwood stage 3 hair loss or higher and you’re under 35, it’s important to monitor your health so you can seek advice from your GP if you develop symptoms of diabetes.
Insulin resistance may also be associated with female pattern hair loss [14]. Female pattern hair loss is less common than male pattern baldness, but it still affects around half of women in their lifetime [13]. So women with hair loss should also be aware of the symptoms of prediabetes, particularly if you have other risk factors too. African American women with diabetes may be at particular risk of developing severe central scalp hair loss [3].
Gestational diabetes is a condition that affects just over a fifth of pregnant women [15]. It’s characterised by increased thirst, frequent urination, dry mouth, and blurred eyesight during pregnancy.
There’s limited research into the impact of gestational diabetes on hair loss, possibly because it’s a short-lived condition that normally resolves after giving birth. Additionally, postpartum hair loss is a very common complaint among women who have recently given birth, so it may be difficult to confirm if gestational diabetes contributes to this hair loss, or whether it’s normal postpartum hair shedding.
While multiple studies have confirmed a link between diabetes and hair loss, the exact cause and effect between the two conditions is still unknown. Here, we explore the mooted reasons diabetes and hair loss may be linked.
Having one autoimmune condition may make you more prone to developing others. Research suggests around 25% of people with an autoimmune condition will develop at least one more, often including a dermatological condition like alopecia areata [16].
Alopecia areata happens when your white blood cells mistakenly attack cells in the follicles, resulting in patchy hair loss.
Other autoimmune conditions may also result in hair loss. These include lupus, scleroderma, and rheumatoid arthritis [17]. If you experience sudden, patchy, or unexplained hair loss, it’s important to seek advice from your GP or a qualified trichologist. They can perform hair loss blood tests to uncover any potential autoimmune conditions.
Controlling and treating diabetes can involve taking several different medications, depending on the type of diabetes you have and its symptoms. Certain diabetes medications may be associated with hair loss.
Treatments like Mounjaro and Ozempic are part of a group of drugs known as GLP-1 (glucagon-like peptide-1) agonists, and are licensed treatments for type 2 diabetes. They work by regulating your blood sugar levels and appetite, improving your metabolic health and often leading to weight loss.
GLP-1 agonists can trigger hair loss in a small minority of users, typically those who experience rapid weight loss [18]. This may be due to the lack of nutrients from reduced food intake. Reported types of alopecia include centrifugal cicatricial alopecia, androgenetic alopecia, and telogen effluvium.
Dipeptidyl peptidase-4 (DPP-4) inhibitors like sitagliptin are also used to treat type 2 diabetes. The DPP-4 enzyme modulates your incretin hormones (GLP-1 and GIP) to improve blood sugar control.
One case report found that taking sitagliptin to suppress DPP-4 led to the development of alopecia universalis — total loss of body hair — in a diabetic patient [19]. Another found that taking linagliptin (another DPP-4 inhibitor) may have contributed to the onset of alopecia areata [20].
These individual case reports don’t necessarily indicate widespread risk, and many patients take DPP-4 inhibitors without losing hair. One study even found that DPP-4 inhibitors may have potential as a treatment for alopecia resulting from scarring and fibrosis [21]. So more evidence is needed to determine the true effect of DPP-4 inhibitors on your hair.
Metformin is a first-line treatment for type 2 diabetes, and works by lowering blood glucose levels.
Metformin isn’t known to cause hair loss. In fact, it’s been shown to improve symptoms of alopecia areata and androgenetic alopecia in some studies [22-24].
Metformin can reduce insulin resistance and limit 5AR activity, potentially improving symptoms of pattern baldness.
Having diabetes can cause significant stress, especially if your condition isn’t well-controlled. Anxiety is more common among people with diabetes, whether it’s due to the demanding daily management of this condition, or worries about potential complications [25].
Chronic stress, worry, and anxiety can trigger a type of hair loss known as telogen effluvium. Telogen effluvium happens when a higher number of follicles than normal are pushed out of the growth phase and into the shedding phase of the hair growth cycle. This causes more hair to fall out than usual.
Telogen effluvium is normally temporary, and will resolve itself when the underlying trigger is addressed. For stress and anxiety, this can include tactics like cognitive behavioural therapy, exercise, mindfulness, and other talking therapies.
Long-term high blood glucose levels can damage the blood vessels, leading to poor circulation. This particularly affects the feet and toes, causing numbness, pain, and tingling.
Poor circulation may affect your hair, too, as it limits the blood flow to the hair follicles [26]. Strong blood flow is needed to provide the follicles with nutrients and oxygen for healthy hair growth.
The relationship between insulin and hair is complex. While insulin doesn’t appear to have a direct impact on hair growth, it does affect other biological functions that can cause problems for your hair. Here’s what we know:
Every case of diabetes-induced hair loss is unique, and is influenced by several different factors. If you have both diabetes and hair loss, it’s important to speak to your GP to discover and address the cause of hair loss.
It’s difficult to tell if diabetes is playing a part in your hair loss, and to what extent this might be the case. Blood tests and other assessments are usually required to determine the underlying cause of complex cases of hair loss. These may be available on the NHS for some diabetic patients, but others will need to see a private trichologist.
Male pattern baldness is by far the most prevalent type of alopecia, and affects the majority of the male population at some stage in their lives. So if you have a receding hairline, hair loss on the crown, or progressive balding that resembles the typical androgenetic alopecia pattern, it’s unlikely to be exclusively due to diabetes.
There are many treatments available to help improve symptoms of hair loss. Some are readily available and can help with multiple types of hair loss, while others may be prescribed or recommended after the underlying cause is diagnosed.
Getting your diabetes under control can help you manage side effects and symptoms, including hair loss. Increased thirst, frequent urination, and high blood glucose readings can be early signs that your diabetes is uncontrolled. See a GP if you think your diabetes symptoms are flaring up or getting worse.
Not all diabetic patients experience hair loss, and there are many more common causes of hair loss. So getting a diagnosis and understanding whether diabetes is a major or minor contributor is the first step to treating diabetes-related hair loss. This can help guide your hair loss treatment decisions.
Here are some effective ways to treat diabetes-related hair loss.
Minoxidil is an over-the-counter topical hair loss treatment. Available in 2% and 5% concentrations, it can help treat a variety of hair loss conditions, including pattern baldness, alopecia areata, and telogen effluvium [32].
Minoxidil is a good first-line treatment to try if you have relatively light hair loss in its early stages. It typically takes at least 3-6 months to start seeing results when using minoxidil.
While some diabetes treatments have been linked with hair loss, many are safe, effective, and unlikely to make your hair fall out. Controlling your diabetes can help resolve or reduce hair loss if the two are related.
While you should never change or stop taking your diabetes medication on a whim, your GP can support you to find the right prescription to control your diabetes while minimising side effects like hair loss.
Whether you’ve had diabetes since a young age or you were diagnosed recently, being diabetic can be highly stressful. To reduce the risk of stress-related hair loss, it’s important to manage your stress effectively. Therapy, exercise, and other stress-busting activities can help tackle stress-related hair loss.
A hair transplant offers a permanent solution to hair loss from pattern baldness. This minimally invasive procedure takes follicles from the back of your scalp and implants them in your balding areas, resulting in long-term regrowth.
People with well-controlled diabetes are often eligible for an FUE or FUT hair transplant. If your diabetes is poorly controlled, you may not be a good candidate for a hair transplant, as your condition may cause problems during the healing process.
Find out if you’re a candidate for a hair transplant at our award-winning hair transplant clinic.
Having diabetes can put you at greater risk of hair loss, whether it’s due to stress, the hormonal impact, or your medication. But it’s far from the only cause of hair loss, so it’s important to understand what’s really making your hair fall out, so you can formulate an effective treatment plan.
At the Wimpole Clinic, we’ll guide you through the entire process, from advanced diagnostics with our trichology team to treatment from our world class hair transplant surgeons. Book a consultation at your nearest Wimpole Clinic location, and we’ll be in touch to find out more about where you are in your hair loss journey, and how we can help.
Learn more about diagnosing and treating diabetes-related hair loss in these frequently asked questions.
It’s not usually possible for patients to uncover what’s causing their hair loss without blood tests and other trichological assessments. Speak to your GP or a trichologist to get a diagnosis.
If your blood sugar levels are poorly controlled, tackling this should be your priority, as this can put your overall health at risk. If you have well-controlled blood sugar but are concerned your diabetes medication is causing hair loss, continue to take your medication as prescribed and contact your GP to discuss your concerns about side effects. They can help you safely adjust your diabetes medication if necessary.
Your doctor may recommend diet changes, especially if you have any nutritional deficiencies, as these can contribute to hair loss.
What you eat can cause blood sugar spikes and other issues, so make sure to follow your GP’s advice before making major changes to your diet.
Patients with controlled diabetes are often candidates for a hair transplant. But if your diabetes is uncontrolled (i.e. you’re experiencing symptoms like high blood glucose levels, increased thirst, and frequent urination) you may not be eligible for a hair transplant. That’s because poorly controlled diabetes can make you prone to hair transplant infection and limit blood flow to the scalp, which is necessary for healing and hair growth.
Wimpole Clinic Services:
Hair Transplants, Beard Transplants & Eyebrow Transplants.
Talk to a specialist
Dr. Michael May (GMC No: 1642315) is the Medical Director and Principal Surgeon of the Wimpole Clinic. He has 25 years experience in the field of hair transplant surgery has completed over 10,000 hair transplant procedures, accumulating an unmatched breadth and depth of experience that is exclusively available to Wimpole Clinic patients.
Dr. May entered private practice in 1982 when he first became involved with hair surgery, since then, he has dedicated his career exclusively to the science and practice of hair transplant surgery and hair restoration.
He qualified at St Bartholomew’s Hospital in London after which he trained and registered as a Fellow of the Royal College of Surgeons. Dr. May was instrumental in developing the revolutionary technique of follicular unit transplant (FUT), and subsequently he also presented papers and lectures in the UK and Europe to professional colleagues. He quickly became recognised by his peers and colleagues as a leader in the field of follicular unit hair transplantation. He specialises in hair restoration surgery covering; FUE, FUT lateral slit, eyebrow, eyelashes, beards, side burns, burns, repairs
As a leading authority in his field, Dr. May became a founder member and past President of the BAHRS and is the current president of the European Society of Hair Restoration Surgeons. In addition, Dr. May is a registered member of The Trichological Society and a Diplomat of Hair Restoration Surgery (ABHRS) in 2002. Dr. Michael May full list of associations are as follows:
Dr. May is available to prospective Wimpole Clinic patients during their consultation and carries out many of the hair transplant procedures at the clinic.
